Aim Lung ultrasound (LUS) has been reported as an accurate predictor for respiratory outcomes by gestational age. The aim of the study was to investigate the relationship between the LUS scores within the first 3 days of life and respiratory outcomes including the need and the duration of invasive mechanical ventilation, and development of bronchopulmonary dysplasia (BPD).

Material and Method It was a retrospective observational study. Preterm infants younger than 32 weeks were included at an academic tertiary NICU between 2018–2023. Lung ultrasound was performed within the first 3 days. LUS scores were noted in two groups as the highest and lowest scores. Statistical analyses were done to predict respiratory outcomes.

Results Total 218 patients were enrolled; 40, 17, and 18 infants had mild, moderate, and severe BPD, respectively. BPD did not develop in 143 patients. Within the first 3 days, the highest and lowest LUS scores significantly predicted moderate-to-severe BPD (P<0.001) (area under ROC curve, 0.684–0.913; area under ROC curve 0.647–0.902; respectively) (figure 1). High LUS scores were also related with the need of mechanical ventilation (P<0.001). We explored cut-off values with respect to gestational age, revealing that the cut-off score was 11 for infants born between 26 weeks 0/7 and 28 weeks 6/7 of gestational age and 12 for those born after 29 weeks 0/7. This observation suggests that as gestational age increases, the corresponding cut-off levels tend to rise as well (table 1). Regression analysis revealed that the highest LUS scores within the first 3 days of life, sepsis, and the presence of hemodynamically significant patent ductus arteriosus (hsPDA) were significantly associated with the severity of BPD.

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Abstract OP-032 Figure 1

ROC analysis for predicting the development of moderate-to-severe bronchopulmonary dysplasia. CI, confidence interval; LUS, lung ultrasound; ROC, receiver operating characteristic.

Conclusions In preterm babies, the LUS scores were useful to predict bronchopulmonary dysplasia. Notably, highest LUS scores within 3 days of life appear to be more reliable indicators, with the understanding that the cutoff LUS scores may vary with gestational age.